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Improved detection of subchondral erosions in the sacroiliac joints with T1-weighted fat-suppressed MRI

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To compare the diagnostic performance of two different sets of magnetic resonance imaging (MRI) for the detection of subchondral erosions in the sacroiliac joints regarding the application of fat-water separation techniques when acquiring T1-weighted (T1w) images, using multi-detector computed tomography (MDCT) as the reference standard.

Methods

We retrospectively included 31 consecutive patients having or being suspected for axial spondyloarthritis (SpA) assessed using both MRI and MDCT. Three sets of images were independently assessed for the presence of erosions by two musculoskeletal radiologists (R1, R2): (1) MRI with standard T1w without fat suppression, (2) MRI with both T1w with and without fat suppression, and (3) MDCT. The diagnostic performance of both sets of MRIs was assessed using MDCT as the referent.

Results

The assessment of T1w images with fat suppression substantially increased sensitivity (76% vs. 63% R1; 70% vs. 60% R2), specificity (97% vs. 84% R1; 96% vs. 81% R2), positive predictive value (85% vs. 45% R1; 81% vs. 40% R2), and overall accuracy (94% vs. 80% R1; 92% vs. 77% R2) in the detection of erosions when compared to the assessment using T1w images without fat suppression.

Conclusion

The assessment of T1w images with fat suppression substantially improves the diagnostic performance of MRI in the detection of erosions in the sacroiliac joints.

Key Points

• The presence of erosions in the sacroiliac joints may influence the decision on the diagnosis of axial spondyloarthritis.

• T1w fat-suppressed MR imaging relatively increases the contrast between the joint space (high signal) and the adjacent subchondral bone (low signal), potentially improving the detection of erosions in the sacroiliac joints.

• T1w fat-suppressed images improve the diagnostic performance of MRI in the detection of erosions in the sacroiliac joints compared to T1w without fat suppression, using MDCT as the reference.

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Abbreviations

ASAS:

Assessment in SpondyloArthritis International Society

IDEAL:

Iterative Decomposition of water and fat Echo Asymmetry and Least squares estimation

MDCT:

Multi-detector computed tomography

MRI:

Magnetic resonance imaging

SpA:

Spondyloarthritis

STIR:

Short tau inversion recovery

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Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Radiology, Saint-Antoine Hospital, Sorbonne University, Paris, France

    Michel D. Crema, Anne Miquel, Arnaud Gouvion, Catherine Phan, Yves Menu & Lionel Arrivé

  2. Institute of Sports Imaging, French National Institute of Sports (INSEP), 11 Avenue du Tremblay, 75012, Paris, France

    Michel D. Crema

  3. Department of Radiology, Boston University School of Medicine, Boston, MA, USA

    Michel D. Crema

  4. Department of Statistics, Pfizer Inc., New York, NY, USA

    Ling Li

Authors
  1. Michel D. Crema
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  2. Anne Miquel
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  3. Arnaud Gouvion
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  4. Catherine Phan
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  5. Ling Li
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  6. Yves Menu
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  7. Lionel Arrivé
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Corresponding author

Correspondence to Michel D. Crema.

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Guarantor

The scientific guarantor of this publication is Michel D. Crema, MD.

Conflict of interest

Professor Yves Menu is the Editor-in-Chief of European Radiology and has therefore not taken part in the review or selection process of this article. One of the authors (Ling Li) is employed by Pfizer Inc. The remaining authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Ling Li) has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• cross sectional study/diagnostic study

• performed at one institution

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Crema, M.D., Miquel, A., Gouvion, A. et al. Improved detection of subchondral erosions in the sacroiliac joints with T1-weighted fat-suppressed MRI. Eur Radiol 31, 6810–6815 (2021). https://doi.org/10.1007/s00330-021-07785-1

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  • DOI: https://doi.org/10.1007/s00330-021-07785-1

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